NPIMap

Organization Active NPI

Harbor Hospice of Victoria LP

  • Community Based Hospice Care Agency
  • Victoria, TX
National Provider Identifier
1881968618
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
014870 Issued in TX
Legal business name
HARBOR HOSPICE OF VICTORIA LP
Practice address
5606 N Navarro St Ste 209
Victoria, TX 77904-1758
Phone
(361) 579-7120
Fax
(361) 333-1749
NPI assigned
Feb 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Karen Carter
Title
Exec Admin Asst
Phone
(409) 730-2046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 014870 TX Primary

Addresses

Primary practice location

5606 N Navarro St Ste 209
Victoria, TX 77904-1758

Mailing address

3406 College St
Suite 200
Beaumont, TX 77701-4612
Phone (409) 813-2332

Other identifiers 2

IdentifierTypeStateIssuer
014870OtherTXTXDADS
001026901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120815000245 TX Part A Provider - Hospice 5799931309 Practice locations: Victoria, TX

Hospice certification: CCN 741502

Legal name
HARBOR HOSPICE OF VICTORIA LP
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 15, 2013
Last certification
Aug 1, 2019
Ownership / control type
Proprietary - Partnership
Organization structure
OtherProprietary
Incorporated
Feb 1, 2012 in TX
Enrollment address
5606 N Navarro St
Ste 209
Victoria, TX 77904-1758

Care Compare: Hospice

Medicare Care Compare
Listed as
Harbor Hospice of Victoria LPCCN 741502
Ownership
For-Profit
Certified
Jul 15, 2013
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

5606 N Navarro St
Ste 209
Victoria, TX 77904
Phone (361) 578-9190

5606 N Navarro St
Ste 306
Victoria, TX 77904

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Karen Carter Individual W-2 Managing Employee Feb 1, 2019
Bryan Gaspard Individual Corporate OfficerMember Feb 1, 2012
W-2 Managing EmployeeAlternate Administrator Feb 1, 2012
Arfeen Properties, L.P. Organization, Beaumont, TX 5% Or Greater Direct Ownership Interest Feb 1, 2012 99%
HHCS Managers LLC Organization, Beaumont, TX LLC General Partnership Interest Feb 1, 2012 1%
Qamar U Arfeen Individual 5% Or Greater Indirect Ownership InterestOwner Feb 1, 2012 50%
Corporate OfficerPresident Feb 1, 2012
Kelley L Arfeen Individual 5% Or Greater Indirect Ownership InterestCo-Owner Feb 1, 2012 50%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 45

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 45

Practitioners & affiliated clinicians

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1881968618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 COLLEGE ST",
            "address_2": "SUITE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014612",
            "telephone_number": "409-813-2332",
            "fax_number": "409-232-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5606 N NAVARRO ST STE 209",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779041758",
            "telephone_number": "361-579-7120",
            "fax_number": "361-333-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HOSPICE OF VICTORIA LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-24",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "EXEC ADMIN ASST",
        "authorized_official_telephone_number": "409-730-2046"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "014870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TXDADS",
            "identifier": "014870",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001026901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.